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Evergree*naly i al Sample Receipt/Ock-i Record <br /> Date & Time Rec'd: - ^,, QDhipped Via: <br /> client : .� g it // (Airbill i if applicable) <br /> Client Project ID(s) : <br /> EAL Project ,i (s) : 92- LISrJ J EAL Cooler(s) : Y V <br /> Cooler# _ l� <br /> Ice packs Yt Y N Y N Y N Y N <br /> Temperature °C �� <br /> Y N N/A <br /> 1. Custody seal (s) present: <br /> Seals on cooler intact <br /> Seals on bottle intact <br /> 2 . Chain of Custody present: ILL <br /> 3 . Containers broken or leaking: <br /> (Comment on COC if Y) <br /> 4 . Containers labeled: <br /> 5. COC agrees w/ bottles received: _ <br /> (Comment on COC if N) <br /> 6. COC agrees w/ labels: T <br /> (Comment on COC if N) <br /> 7 . Headspace in VOA vials-waters only <br /> (comment on COC if Y) <br /> 8 . VOA samples preserved: <br /> 9. pH measured on preserved non-VOA containers: _ _ <br /> List discrepancies <br /> 10. Dissolved metals samples present: <br /> To be preserved: —�- <br /> To be filtered: <br /> 11. Short holding times: <br /> Specify parameters <br /> 12 . Multi-phase sample(s) present: <br /> 13 . COC signed w/ date/time: �C <br /> Comments: <br /> (Additional comments on ba ky <br /> Custodian Signature/Da e: <br />